Hot or Immediate Tonsillectomy: A Safe and Effective Method for Treatment of Acute Tonsillitis’ Complications

Abstract

Aim: The aim of this study was retrospective analysis of indications to hot tonsillectomy, its effectiveness and safety. Peritonsillar abscess (PTA) is one of the most common complications of acute tonsillitis and the cause of emergency laryngological counselling. In some cases, it is necessary to perform hot tonsillectomy. Material and Methods: In between 2009-2015, 21 patients (aged between 4 to 43 years old) with an initial diagnosis of peritonsillar abscess were admitted. Among them, 11 were women and 10 were men. All underwent hot tonsillectomy. Results: Most of the patients were between 20-40 years old. The most common symptoms were pain in the throat, trismus and dysphagia. In all cases incision of an abscess was made, in 9 patients purulent discharge was present. In all patients there was no relief of symptoms after incision and antibiotic therapy. In 12 cases without drainage after initial incision, pus was drained after tonsillectomy. In the remaining 9 cases there were additional reservoirs of pus, which were drained after surgery in 6 patients. In 8 patients there was more than one localization of an abscess. There were no problems with intubation and no complications in the early and late post-operative periods occurred. The average time of stay in hospital was 8 days (5-12 days). Conclusion: Lack of improvement after initial treatment of PTA is an indication to hot tonsillectomy. This procedure is not connected with an increased risk of complications. Evacuation of purulent content does not exclude presence of another abscess, unusual localization or parapharyngeal space abscess.